摘要：
BACKGROUND: The importance of self-management behavior has been widely acknowledged in global studies, demonstrating its effectiveness in improving patients' emotional well-being, enhancing quality of life, preventing stroke recurrence, and reducing mortality and readmission rates. However, existing research indicates that self-management behavior among older adults hospitalized for stroke remains underdeveloped. Furthermore, limited studies have examined the correlations between self-management behavior, family care, and chronic disease resource utilization in this population. OBJECTIVE: This study aims to investigate self-management behavior, family care, and chronic disease resource utilization among Chinese older adults hospitalized for stroke and to explore the relationships among these variables. Specifically, it examines the mediating role of chronic disease resource utilization between self-management behavior and family care. METHODS: A cross-sectional correlational design followed the Strengthening the Reporting of Observational Studies in Epidemiology checklist for quality reporting. Between December 2023 and January 2025, a total of 627 Chinese older adults hospitalized for stroke were recruited from three tertiary grade-A hospitals in two cities in China. Data were collected using the Demographic Characteristics Questionnaire, the Stroke Patient Self-Management Behavior Assessment Scale, the Family APGAR Scale, and the Chronic Illness Resources Survey. Descriptive statistics, univariate analysis, correlation analysis, and process plug-in mediation effect analysis were applied to the data. RESULTS: The total scores for self-management behavior, family care, and chronic disease resource utilization were (M = 165.94, SD = 51.26), (M = 5.51, SD = 1.65), and (M = 72.15, SD = 16.73), respectively. These scores indicate moderate levels of self-management behavior, family care, and chronic disease resource utilization. Self-management behavior was positively correlated with family care (r = 0.615, p < 0.01) and chronic disease resource utilization (r = 0.536, p < 0.01). Furthermore, chronic disease resource utilization partially mediated the relationship between self-management behavior and family care, accounting for 41.6% of the total effect. CONCLUSION: The self-management behavior, family care, and chronic disease resource utilization among Chinese older adults hospitalized for stroke were found to be at moderate levels, indicating a need for improvement. Family care directly affects self-management behavior and indirectly affects it through chronic disease resource utilization. Healthcare professionals should focus on enhancing health education and providing psychological support for stroke patients to improve family care, alleviate fears regarding disease progression, and ultimately promote better self-management behavior.
期刊：
FRONTIERS IN NUTRITION,2025年12:1648314 ISSN：2296-861X
通讯作者：
Liu, DB
作者机构：
[Wu, Ruiyu; Liu, Dongbo; Zhou, Xu; Chen, Xuan; Luo, Wu; Xiao, Zhiyong; Yang, Xiao; Zhou, Jiali] Hunan Agr Univ, Coll Hort, Changsha, Peoples R China.;[Xiao, Zhiyong; Yin, Xinhong] Univ South China, Sch Nursing, Hengyang, Peoples R China.;[Lai, Xihu] Xincheng Smart Internet Hosp, Chengdu, Peoples R China.;[Liu, Dongbo; Zhou, Xu; Chen, Xuan; Luo, Wu] Yuelushan Lab, Changsha, Peoples R China.;[Zhang, Yewu] Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China.
通讯机构：
[Liu, DB ] H;Hunan Agr Univ, Coll Hort, Changsha, Peoples R China.;Yuelushan Lab, Changsha, Peoples R China.;Hunan Prov Engn Res Ctr Med Nutr Intervent Technol, Changsha, Peoples R China.
摘要：
AIMS: Randomized controlled trials (RCTs) have demonstrated that intermittent calorie-restricted diet (ICR) can lead to diabetes remission. We aimed to assess the diabetes remission with ICR among patients with type 2 diabetes (T2D) in real-world settings. MATERIALS AND METHODS: We performed a retrospective, dual-cohort study (January 2022-July 2023) using real-world data from Chinese patients with T2D. The ICR cohort consisted of 1,069 patients following an intermittent calorie-restricted diet, while the control cohort consisted of 1,099 patients receiving Dietary Guidelines for Diabetes in China (2017 Edition). The primary outcome was diabetes remission. Secondary outcomes included reductions in antidiabetic medication use and changes in fasting blood glucose (FBG). Subgroup evaluations for the sensitivity analysis were conducted to further assess outcomes. The study employed a combination of univariate and multivariate analyses, including Linear Mixed-Effects Models (LMM), Generalized Linear Mixed-Effects Models (GLMM), and Cox regression with propensity score-weighted Inverse Probability Weighting (IPW), to evaluate relationships between cohort and outcomes. RESULTS: In real-world settings, the ICR cohort achieved significantly higher remission rates (20% vs. 2%, p < 0.001), greater medication reduction (61% vs. 22%, p < 0.001). After IPW adjustment, ICR remained superior for remission (OR: 11.02, 95% CI: 8.12-14.96) and reduce medication usage (Estimate: 6.26, 95% CI: 5.61-6.99, p < 0.001). Subgroup analyses confirmed consistent benefits across FBG levels and diabetes durations. CONCLUSION: This study demonstrated the practical efficacy of ICR in achieving diabetes remission. These findings establish dietary interventions as a powerful and viable strategy for T2D remission.
作者：
Liang, Cong;Huang, Xinlin;Pu, Yucui;Zhang, Pei;Wang, Rong
期刊：
JOURNAL OF STROKE & CEREBROVASCULAR DISEASES,2025年34(1):108104 ISSN：1052-3057
通讯作者：
Wang, R
作者机构：
[Wang, Rong; Zhang, Pei; Liang, Cong] Univ South China, Sch Nursing, Heng Yang 421001, Peoples R China.;[Liang, Cong] Yellow River Conservancy Commiss, Yellow River Ctr Hosp, Zhengzhou 450000, Peoples R China.;[Huang, Xinlin] Hong Kong Polytech Univ, Hong Kong, Peoples R China.;[Pu, Yucui] Chongqing Presch Educ Coll, Chongqing, Peoples R China.
通讯机构：
[Wang, R ] U;Univ South China, Sch Nursing, Heng Yang 421001, Peoples R China.
关键词：
Walking pace;Stroke;Mendelian randomization;Genome-wide association study
摘要：
Background Walking pace (WP), a simple physiological indicator, has been found to be strongly associated with a variety of health outcomes in recent years. Among them, the relationship between walking pace and stroke is of particular interest. Given the high morbidity, disability and mortality associated with stroke, identifying modifiable indicators of health, such as walking pace, could help in stroke prevention strategies. However, the causal relationship between WP and stroke risk remains unclear. This study aims to determine the causal relationship between walking pace and risk of stroke using a two-sample Mendelian randomization approach in a European-ancestry population.
Walking pace (WP), a simple physiological indicator, has been found to be strongly associated with a variety of health outcomes in recent years. Among them, the relationship between walking pace and stroke is of particular interest. Given the high morbidity, disability and mortality associated with stroke, identifying modifiable indicators of health, such as walking pace, could help in stroke prevention strategies. However, the causal relationship between WP and stroke risk remains unclear. This study aims to determine the causal relationship between walking pace and risk of stroke using a two-sample Mendelian randomization approach in a European-ancestry population.
Methods In order to evaluate the potential for a causal relationship between WP and stroke in people of European heritage, a two-sample Mendelian randomization (MR) study was carried out. Statistics about the association of single nucleotide polymorphisms (SNPs) with stroke were taken from FinnGen (R8) (n = 284,040), while the UK Biobank genome-wide association studies (GWAS) provided the summary data on the association of SNPs with WP (n = 459,915). The inverse-variance weighted (IVW) method was utilised as the primary strategy to examine the causal connection between WP and stroke. Additionally, complementary analyses were conducted using the MR-Egger and weighted median. In order to identify the potential directional pleiotropy and heterogeneity, the MR-Egger intercept test, the MR-PRESSO test, and Cochran's Q statistic were all carried out. This connection was evaluated using OR with 95% confidence intervals (CIs).
In order to evaluate the potential for a causal relationship between WP and stroke in people of European heritage, a two-sample Mendelian randomization (MR) study was carried out. Statistics about the association of single nucleotide polymorphisms (SNPs) with stroke were taken from FinnGen (R8) (n = 284,040), while the UK Biobank genome-wide association studies (GWAS) provided the summary data on the association of SNPs with WP (n = 459,915). The inverse-variance weighted (IVW) method was utilised as the primary strategy to examine the causal connection between WP and stroke. Additionally, complementary analyses were conducted using the MR-Egger and weighted median. In order to identify the potential directional pleiotropy and heterogeneity, the MR-Egger intercept test, the MR-PRESSO test, and Cochran's Q statistic were all carried out. This connection was evaluated using OR with 95% confidence intervals (CIs).
Results A total of 48 SNPs were identified as valid instrumental variables in our two-sample MR analysis. The result showed that a slower walking pace is associated with a higher risk of stroke (OR = 0.573; 95% CI, 0.383-0.858, P = 0.007). The “leave-one-out” analysis demonstrated that the absence of a single SNP did not affect the robustness of our results. The MR-Egger intercept test indicated that genetic pleiotropy did not introduce bias into the results [intercept = −2.9E−03, SE = 0.008, P = 0.719] and Cochran's Q test revealed no heterogeneity. Therefore, the sensitivity analyses yielded comparable results. Consequently, the results of the sensitivity analyses were consistent.
A total of 48 SNPs were identified as valid instrumental variables in our two-sample MR analysis. The result showed that a slower walking pace is associated with a higher risk of stroke (OR = 0.573; 95% CI, 0.383-0.858, P = 0.007). The “leave-one-out” analysis demonstrated that the absence of a single SNP did not affect the robustness of our results. The MR-Egger intercept test indicated that genetic pleiotropy did not introduce bias into the results [intercept = −2.9E−03, SE = 0.008, P = 0.719] and Cochran's Q test revealed no heterogeneity. Therefore, the sensitivity analyses yielded comparable results. Consequently, the results of the sensitivity analyses were consistent.
Conclusion Our MR study revealed that WP is inversely associated with risk of stroke. These results provided evidence that slower WP causally increased the risk of stroke, recommending that patients with lower WP should have a prompt physical examination and targeted interventions to reduce their risk of stroke and enhance their quality of life.
Our MR study revealed that WP is inversely associated with risk of stroke. These results provided evidence that slower WP causally increased the risk of stroke, recommending that patients with lower WP should have a prompt physical examination and targeted interventions to reduce their risk of stroke and enhance their quality of life.
摘要：
INTRODUCTION: Although chronic endometritis (CE) is strongly associated with infertility and adverse pregnancy outcomes, the specific microbiome of women with CE who can conceive remain unclear. METHODS: This study recruited 100 participants aged 18 to 45 years with spontaneously conceived pregnancy who opted for pregnancy termination, detected their endometrial microbiome by 16S rRNA, and made a diagnosis of CE. RESULTS: Among them, 19 were diagnosed with CE. There was a comparable microbial composition within the endometrium between women with and without CE. The relative abundance of Sphingomonas (21%) and Pseudomonas (8%) were the same in both groups. Compared to women without CE, women with CE exhibited higher abundance of Faecalibacterium (6.5% vs 3.8%), Escherichia-Shigella (3.3% vs 2.6%), Akkermansia (1.65% vs 1.1%), and lower abundance of Lactobacillus (10% vs 14%), and Corynebacterium (1.35% vs 2.15%) at the genus level. Streptococcus, Escherichia-Shigella, Akkermansia and Finegoldia exhibited significant interactions with other microbiome in participants with CE. DISCUSSION: In women with CE, reproductive potential may be associated with the compositional stability of the endometrial microbiome, whereas an imbalance in the abundance of these microbes may be linked to their pregnancy outcomes.
期刊：
International Journal of General Medicine,2025年18:2823-2838 ISSN：1178-7074
通讯作者：
Hu, HJ
作者机构：
[Mi, Ziyi; Zhang, Bingxue] Univ South China, Sch Nursing, Hengyang 421000, Hunan, Peoples R China.;[Hu, Hongjuan] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Publ Hlth Serv, Hengyang 421001, Hunan, Peoples R China.;[Liu, Haidi] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Rehabil Med, Hengyang 421001, Hunan, Peoples R China.
通讯机构：
[Hu, HJ ] U;Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Publ Hlth Serv, Hengyang 421001, Hunan, Peoples R China.
关键词：
exercise;hypertension;older;population health management;systematic review
摘要：
PURPOSE: This study was based on the PICO framework to systematically evaluate the effects of aerobic exercise on key health management indicators such as blood pressure, heart rate and cardiorespiratory fitness in older hypertensive patients. PATIENTS AND METHODS: A systematic search of randomized controlled trials from four English language databases, Web of Science, PubMed, Cochrane, and Embase, and four Chinese language databases, CNKI, VIP, Wanfang, and Sinomed, was performed (April 2014 to April 2024). StataCorp Stata v.18.0 was used for data analysis. In a random-effects meta-analysis, continuous variables were represented by the mean difference, and each effect size was represented by a 95% confidence interval. RESULTS: Nine randomized controlled trials with 484 participants were included. The meta-analysis revealed that compared with the control group, participants engaging in aerobic exercise significantly reduced systolic blood pressure (SMD = -0.93, 95% CI = -1.48 to -0.39, P =0.001), diastolic blood pressure (SMD = -0.48, 95% CI = -0.75 to -0.21, P =0.001), and heart rate (SMD = -1.78, 95% CI = -3.31 to -0.24, P =0.024), and improved cardiorespiratory health (SMD =0.71, 95% CI =0.24 to 1.18, P =0.003). CONCLUSION: Older patients with hypertension aged 60 years should engage in 120-150minutes of low- to moderate-intensity aerobic exercise per week, maintaining 40-75% maximum HR or 40-60% VO(2)max (20-30minutes per day, 5 days per week, or 75-150minutes of exercise only once or twice a week. However, it is crucial that individuals assess their own health conditions, make appropriate time adjustments, and gradually increase the duration and intensity of exercise. And central randomization with blinded assessment should be used in future randomized controlled trials to reduce implementation bias and measurement bias.
摘要：
China is experiencing an increasingly serious aging population. Cognitive function is an important factor and guarantee for the quality of life of older people. Therefore, to achieve healthy aging, this study aimed to examine the sequential multiple mediating effects of indoor ventilation frequency and cognitive function on anxiety and self-rated health in the Chinese older people population. Using the 2018 China Longitudinal Health and Longevity Survey (CLHLS) dataset, we finally selected 10,372 Chinese seniors over the age of 65. First, we describe the basic socio-demographic information of the sample population. Second, Spearman correlation analysis was used to determine whether there was a correlation between indoor ventilation frequency, anxiety, self-rated health, and cognitive function among Chinese older people. Finally, the SPSS macro process program was used to complete the sequence multiple mediation analysis. Indoor ventilation frequency, anxiety, self-rated health and cognitive function were significantly correlated (p < 0.01). Indoor ventilation frequency not only has a direct positive impact on the cognitive function of older people (effect = 0.1427; Standard error = 0.0201; 95%CI: LL = 0.1034, UL = 0.1821), but also indirectly affected cognitive function through three pathways: independent mediation of anxiety (effect = 0.0078; Standard error = 0.0021; 95%CI: LL = 0.0041, UL = 0.0121), independent mediating effect of self-rated health (effect = 0.0154; Standard error = 0.0030; 95%CI: LL = 0.0098, UL = 0.0215), and the chain mediating effect between anxiety and self-rated health (effect = 0.0046; Standard error = 0.0009; 95%CI: LL = 0.0029, UL = 0.0065). All projects are self-reported and some results may be biased. In the future, it may be more inspiring to explore more detailed and specific effects of indoor air quality on cognitive function in older people. Studies have shown that indoor ventilation frequency can improve cognitive function by reducing anxiety and improving self-rated health in older people Chinese. Encouraging older adults to increase the frequency of indoor ventilation will benefit their mental health and cognitive function. This study provides empirical evidence for the association between indoor ventilation frequency and cognitive function in older people Chinese adults. We used nationally representative data to investigate the relationship between indoor ventilation frequency and cognitive function and further explored the mediating role of anxiety and self-rated health in Chinese older adults. Indoor ventilation frequency can not only directly affect cognitive function in older people, but also indirectly affect cognitive function through anxiety and self-rated health. Anxiety and self-rated health have a series of mediating effects between indoor ventilation frequency and cognitive function.
摘要：
The orthopedic potential of biodegradable iron (Fe)-manganese (Mn)-copper (Cu) alloys remains insufficiently defined, necessitating comprehensive investigation into their mechanical properties, wear resistance, magnetic resonance imaging compatibility, biodegradation behavior, antibacterial efficacy, cytocompatibility, and osteogenic differentiation capacity. This study systematically addresses these aspects through microstructural characterization, mechanical testing, and biological evaluations of Fe-30Mn-6Cu alloy fabricated via selective laser melting (SLM). For comparison, a Cu-free Fe-30Mn alloy was fabricated under similar SLM conditions. The incorporation of 6 wt.% Cu into Fe-30Mn stabilized the gamma-austenite phase, enhanced yield strength, improved wear resistance, accelerated electrochemical biodegradation, and imparted strong antibacterial activity. The SLMed Fe-30Mn-6Cu (i) exhibited a fully gamma-austenite microstructure with fine equiaxed grains (similar to 7 mu m) containing Cu-enriched intergranular second-phase particles; (ii) demonstrated a yield strength of similar to 230 MPa-approximately similar to 24% higher than that of SLMed Fe-30Mn-along with improved tribological performance, a reduced hysteresis loop area indicating extremely low saturation magnetization and magnetic susceptibility, and a biodegradation rate three times higher compared to the Cu-free counterpart; and (iii) achieved a bacteriostatic rate exceeding 99% against Escherichia coli and Staphylococcus aureus, alongside excellent cytocompatibility and promotion of osteogenic differentiation in MC3T3-E1 cells.These findings provide insights into the structure-property-function relationship of multifunctional Fe-Mn-Cu alloys and their promising applicability in orthopedic implants.
作者机构：
[Tang, Ke; Shao, Xiaodan; Zhang, Yan; Wang, Na; Zhang, Y] Univ South China, Sch Nursing, 28 Changsheng West Rd, Hengyang 421001, Hunan, Peoples R China.;[Jiang, Yuting; Zhang, Yan; Wang, Kunning; Zhang, Y; Shen, Zhiwei] Univ South China, Inst Pathogen Biol, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.;[Tan, Zhangyan; Xie, Jiangxiu] Univ South China, Affiliated Hosp 2, Dept Obstet, Hengyang 421001, Hunan, Peoples R China.
通讯机构：
[Zhang, Y ] U;Univ South China, Sch Nursing, 28 Changsheng West Rd, Hengyang 421001, Hunan, Peoples R China.;Univ South China, Inst Pathogen Biol, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.
摘要：
OBJECTIVE: To provide an overview of the symptom experience and interrelationships among symptoms during chemotherapy in cancer patients, as well as the state of symptom network research in this field. METHODS: This scoping review was conducted using the framework proposed by Arksey and O'Malley and the PRISMA guidelines. It included studies that focused on symptom network analysis of cancer patients currently undergoing chemotherapy treatment. A comprehensive search was conducted in both English and Chinese databases, including PubMed/MEDLINE, Cochrane, EMBASE, CINAHL (EBSCO), Web of Science, ProQuest, CNKI, VIPC, and CSPD, up to September 10, 2024.Studies were included if they involved cancer patients aged ≥ 18years undergoing chemotherapy and excluded those involving radiotherapy. Data were extracted based on study characteristics, cancer types, sample characteristics, treatment, study design, instruments, R packages used, core symptoms, and main findings. RESULTS: From 8948 initial articles, 12 studies were included. These studies varied in sample size, symptom survey instruments, and methods of symptom categorization. Six studies extracted symptom clusters, and core symptoms were identified in eight studies. Fatigue was commonly reported as a core symptom across different cancer types. The longitudinal study indicated that overall symptoms peaked after the initial chemotherapy session and gradually decreased with subsequent cycles, although some symptoms like skin changes and neuropathy worsened over time. CONCLUSIONS: Symptom network analysis offers insights into the complex interplay of symptoms during chemotherapy, highlighting fatigue as a central symptom. Future research should focus on longitudinal studies to better understand the dynamic changes in symptom networks and their implications for symptom management interventions.
期刊：
FRONTIERS IN ENDOCRINOLOGY,2025年16:1504609 ISSN：1664-2392
通讯作者：
Gao, Hong;Wu, BY;Gao, H
作者机构：
[Gao, Hong; Wu, Baoyu] Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Dept Nursing, Hengyang, Hunan, Peoples R China.;[Gao, Hong] Ottawa Hosp, Res Inst, Ottawa, ON, Canada.;[Liang, Bingyan; Xiao, Jing] Univ South China, Sch Nursing, Hengyang, Hunan, Peoples R China.;[Li, Genlin; Wang, Xiaolan] Univ South China, Affiliated Hosp 1, Ctr Combinat Obstet & Gynecol & Reprod Med, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.;[Li, Huanhuan] Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Dept Gynecol, Hengyang, Hunan, Peoples R China.
通讯机构：
[Gao, H ] O;[Wu, BY ; Gao, H] U;Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Dept Nursing, Hengyang, Hunan, Peoples R China.;Ottawa Hosp, Res Inst, Ottawa, ON, Canada.
摘要：
INTRODUCTION: Recurrent implantation failure (RIF) is a major challenge in reproductive medicine, and emerging evidence suggests that alterations in the endometrial microbiota may play a critical role in its pathogenesis. To identify the main differential endometrial microbiota associated with RIF and to establish threshold values for their relative abundance. METHODS: This case-control study was conducted in the Departments of Obstetrics, Gynecology, and Reproductive Medicine at two large hospitals. From March to December 2023, the study recruited 17 infertile patients with RIF (Group A, cases), 19 healthy non-pregnant women (Group B, controls), and 20 healthy pregnant women (Group C, controls). Demographic information, medication history, clinical data, and endometrial tissue samples were collected. Endometrial microbiota of all participants was profiled using 16S rRNA gene sequencing. RESULTS: The richness of endometrial microbiota in Group A was significantly lower compared to both control groups (P=0.013, P=0.022, respectively). The diversity of endometrial microbiota in Group A and B was significantly higher compared to Group C (P=0.043, P=0.002, respectively). The composition of endometrial microbiota in Group A differed significantly from both control groups, whereas only minor differences were observed between the two control groups (PERMANOVA, P=0.001). Methyloversatilis, Lactobacillus, Sphingomonas, Faecalibacterium, Escherichia-Shigella, Bacteroides, and Aeromonas were identified as the main differential endometrial microbiota associated with RIF, with threshold relative abundances of 3.807%, 6.606%, 0.192%, 0.193% , 0.618%, 2.411%, and 0.019%, respectively. In Group A, Lactobacillus was positively correlated with Sphingomonas (r=0.64, P=0.005). DISCUSSION: Methyloversatilis, Lactobacillus, Sphingomonas, Faecalibacterium, Escherichia-Shigella, Bacteroides, and Aeromonas were the main differential endometrial microbes associated with RIF. Preliminary threshold values for their relative abundances were established.
摘要：
Aim To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
To explore and explain the mechanisms that influence surface acting in nursing students with different characteristics.
Background Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Nurses are now expected to deliver patient-centered care which necessitates the emotional labor. Surface acting, a form of emotional labor, can lead to negative outcomes. Given that nursing students are the backbone of the future nursing profession, there is an urgent need to investigate their surface acting tendencies and identify potential factors for early intervention.
Design A cross-sectional study.
A cross-sectional study.
Methods This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
This study was surveyed in a vocational college in Gansu, China. Participants completed the general information questionnaire, Bem Sex Role Inventory, Professional Identity Questionnaire of Nursing Students and Surface Acting Scale. K-means cluster analysis was performed, followed by random forest algorithm and SHapley Additive exPlanations based on Python program.
Results A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
A total of 1241 nursing students from vocational college were investigated and were clustered into 4 groups. The five dimensions of professional identity had higher feature importance in all four groups, with professional self-image having the highest feature importance in Cluster 3. Professional self-image and understanding retention benefits and turnover risks were negative predictors of surface acting in all four groups. Social comparison and self-reflection, independence of career choice and social modeling regarding nursing profession were positively correlated with surface acting in specific groups. In Cluster 1, there exists a positive correlation between professional self-image and the constructs of social comparison and self-reflection; as well as a negative correlation between maternal education and understanding of retention benefits and turnover risks.
Conclusions Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
Professional identity significantly influences surface acting behaviors among nursing students, with professional self-image serving as a key negative predictor. Positive family conditions, access to educational resources, parental literacy, masculine or feminine gender roles and first-year nursing students, these traits have implications when dimensions of professional identity are used to predict surface acting behaviors.
摘要：
OBJECTIVE: While growing evidence supports the Geriatric Nutritional Risk Index (GNRI) as a prognostic indicator for various cancers, its predictive value in pancreatic cancer remains unclear. This meta-analysis systematically evaluates GNRI's ability to predict postoperative complications and long-term outcomes in pancreatic cancer patients. METHODS: We conducted a comprehensive literature search across nine databases (Web of Science, PubMed, Embase, Cochrane Library, Scopus, WanFang, CNKI, VIP, and SinoMed) through June 1, 2025. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess overall survival (OS), while risk ratios (RRs) with 95% CIs evaluated postoperative complications. RESULTS: From 233 initially identified studies, 10 met inclusion criteria (n = 2,003 patients). Pooled analysis revealed that lower GNRI significantly predicted worse OS (HR = 1.92, 95% CI 1.54-2.41, p < 0.0001) and higher postoperative pancreatic fistula (POPF) incidence (RR = 0.18, 95% CI 0.08-0.43, p < 0.001). No significant association was found between GNRI and post-pancreatectomy hemorrhage (PPH) (RR = 0.21, 95% CI 0.03-1.53, p = 0.13). CONCLUSION: GNRI shows promise as a clinically useful predictor of OS and POPF in pancreatic cancer patients. However, these findings require validation through prospective multicenter studies. SYSTEMATIC REVIEW REGISTRATION: Identifier CRD42023409362.
期刊：
FRONTIERS IN ONCOLOGY,2025年15:1515502 ISSN：2234-943X
通讯作者：
Yan, YY
作者机构：
[Mo, Wenjuan; Li, Mengnan] Univ South China, Sch Nursing, Hengyang Med Sch, Hengyang, Hunan, Peoples R China.;[Yan, YY; Yan, Yuanyuan; Fu, Guang] Univ South China, Affiliated Hosp 1, Dept Gastrointestinal Surg, Hengyang, Peoples R China.
通讯机构：
[Yan, YY ] U;Univ South China, Affiliated Hosp 1, Dept Gastrointestinal Surg, Hengyang, Peoples R China.
关键词：
best evidence;gastric cancer;intervention strategies;prevention;pulmonary complications
摘要：
BACKGROUND: Postoperative pulmonary complications in gastric cancer surgery significantly impact patient recovery and prognosis. These complications, including infections, can increase hospital stays and costs, and even lead to death. Numerous risk factors are involved, such as age, smoking history, and lung function. Although preventive measures exist, a unified and effective strategy is lacking. Therefore, researching and implementing effective prevention measures is crucial for improving patients' postoperative quality of life and survival rates. AIM: To collate and summarize the best available evidence for the prevention of pulmonary complications in patients undergoing gastric cancer surgery, thereby providing a reference for the clinical development of relevant intervention strategies. METHODS: A literature search was conducted in databases including BMJ Best Practice, UpToDate, JBI, Cochrane Library, PubMed, Embase, the Ontario Nurses Registration Network, the U.S. National Clinical Practice Guidelines, and MedLine, for documents related to the prevention of pulmonary complications in gastric cancer surgery patients. The search period extended from the inception of these databases to July 25, 2024. The quality of the literature was evaluated according to the standards of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, and evidence was extracted from the included documents. RESULTS: A total of 27 documents were ultimately included. The extracted content encompassed three areas: preoperative assessment, risk prevention and intervention measures, totaling 31 best evidences across five categories. The findings of our study underscore the significance of comprehensive preoperative assessments, such as the ARISCAT index for pulmonary risk evaluation, and stress the importance of preoperative interventions like inspiratory muscle training, smoking cessation, and oral care in mitigating postoperative pulmonary complications (PPCs) following gastric cancer surgery. We also advocate for the adoption of protective lung ventilation strategies during surgery and continuous pulse oximetry monitoring postoperatively, along with targeted treatments for specific complications. CONCLUSION: The best evidence extracted for the prevention of complications in gastric cancer surgery patients serves as a basis for evidence-based practice for the prevention of pulmonary complications in this patient group. Further research topics on pulmonary complications of gastric cancer, we recommend further optimization of preoperative assessment tools, investigation into the efficacy of smoking cessation programs, comparative studies on intraoperative ventilation strategies, development of postoperative rehabilitation programs, and research into culturally and resource-sensitive interventions to broaden the global applicability of these practices.
摘要：
Genital tract Chlamydia trachomatis (Ct) infection is one of the most prevalent sexually transmitted infections (STIs) worldwide. However, its clinical progression is often insidious and prolonged. Understanding the mechanisms by which Ct influences cell death pathways is crucial for elucidating the pathogenic processes of this intracellular bacterium . Ferroptosis , a newly identified form of programmed cell death , is characterized by the iron-dependent accumulation of lipid peroxides . Despite its relevance, the interaction between Ct and ferroptosis remains poorly studied. In the present study, we first performed bioinformatics analysis based on RNA sequencing data under an in vitro model of Ct acute infection. Bioinformatics analysis revealed significant enrichment of differentially expressed genes in ferroptosis and p53 signaling pathways . Subsequently, we validated the hypothesis that Ct inhibits host ferroptosis by expression assays of ferroptosis-related proteins. Further cell proliferation , intracellular ferrous iron fluorescence, and lipid peroxidation assays multifaceted observations of the phenotype. Mechanistically, we found that Ct inhibition of ferroptosis acts by regulating the host p53/SLC7A11 pathway. Finally, indirect immunofluorescence assays demonstrated that ferroptosis decreases inclusion forming units (IFUs) of Ct progeny and thus affects its reproduction, which partly explains Ct 's survival strategy of resisting host ferroptosis.
Genital tract Chlamydia trachomatis (Ct) infection is one of the most prevalent sexually transmitted infections (STIs) worldwide. However, its clinical progression is often insidious and prolonged. Understanding the mechanisms by which Ct influences cell death pathways is crucial for elucidating the pathogenic processes of this intracellular bacterium . Ferroptosis , a newly identified form of programmed cell death , is characterized by the iron-dependent accumulation of lipid peroxides . Despite its relevance, the interaction between Ct and ferroptosis remains poorly studied. In the present study, we first performed bioinformatics analysis based on RNA sequencing data under an in vitro model of Ct acute infection. Bioinformatics analysis revealed significant enrichment of differentially expressed genes in ferroptosis and p53 signaling pathways . Subsequently, we validated the hypothesis that Ct inhibits host ferroptosis by expression assays of ferroptosis-related proteins. Further cell proliferation , intracellular ferrous iron fluorescence, and lipid peroxidation assays multifaceted observations of the phenotype. Mechanistically, we found that Ct inhibition of ferroptosis acts by regulating the host p53/SLC7A11 pathway. Finally, indirect immunofluorescence assays demonstrated that ferroptosis decreases inclusion forming units (IFUs) of Ct progeny and thus affects its reproduction, which partly explains Ct 's survival strategy of resisting host ferroptosis.
作者机构：
[Wen, Ying; Zhang, Qun-Xiang; Gong, You-Wen] Cent South Univ, Changde Hosp, The Peoples Hosp Changde City 1, Xiangya Sch Med,Dept Nursing, 818 Renmin Rd, Changde 415000, Hunan, Peoples R China.;[Liu, Yang] Univ South China, Sch Nursing, Hengyang 421001, Hunan, Peoples R China.;[He, Xiao-Hua] Cent South Univ, Xiangya Hosp 2, Clin Nursing Teaching & Res Sect, Changsha 410011, Hunan, Peoples R China.
通讯机构：
[Gong, YW ] C;Cent South Univ, Changde Hosp, The Peoples Hosp Changde City 1, Xiangya Sch Med,Dept Nursing, 818 Renmin Rd, Changde 415000, Hunan, Peoples R China.
关键词：
Chain mediation model;Coping with death competence;Death anxiety;Death attitude;Oncology nurses;Resilience
摘要：
BACKGROUND: Death anxiety (DA) is a prevalent psychological challenge among oncology nurses that affects their emotional well-being and professional competence in coping with death-related situations. Death-related attitudes and resilience are critical factors that may mediate the relationship between DA and coping with death competence (CDC). However, few studies have examined the chain-mediating effect of these factors among Chinese oncology nurses. This study aimed to investigate the association between DA and CDC among Chinese oncology nurses, with a focus on the mediating roles of death attitude and resilience. AIM: To investigate the association between DA and CDC among Chinese oncology nurses. METHODS: A national cross-sectional survey was conducted among Chinese oncology nurses using an electronic questionnaire distributed in Wenjuanxing, China. In total, 615 valid responses were obtained. The participants completed the Templer death anxiety scale, death attitude profile-revised, Connor-Davidson resilience scale, and coping with death scale. A chain mediation analysis was performed using the PROCESS macro in SPSS to examine the relationships between these variables. RESULTS: The findings indicated that DA had a significant direct effect on CDC [effect = 0.201, 95% confidence interval (CI): 0.112-0.322]. In addition to this direct effect, three significant indirect pathways were observed: (1) Death attitude (effect = 0.118, 95%CI: 0.056-0.163); (2) Resilience (effect = 0.108, 95%CI: 0.032-0.176); and (3) A sequential mediation pathway involving both death attitude and resilience (effect = 0.071, 95%CI: 0.042-0.123). The total indirect effects of the three mediation paths accounted for 29.7% of the relationship between DA and CDC. CONCLUSION: Using a chain mediation model, this study explored the mechanisms linking DA, death attitude, resilience, and CDC among Chinese oncology nurses. These findings highlighted the crucial role of death attitude and resilience in mediating the relationship between DA and CDC. Interventions aimed at fostering adaptive attitudes toward death and enhancing resilience may improve nurses' ability to cope with death-related stressors, ultimately benefiting their psychological well-being and professional competence.
作者机构：
[Li, C.; Hu, A.; You, Z.] Jinhua Univ Vocat Technol, Sch Med, Jinhua 321000, Zhejiang, Peoples R China.;[Liu, X.; Liu, Y.; Liu, F.; Liao, L.] Univ South China, Sch Nursing, Hengyang 421001, Hunan, Peoples R China.;[Li, W.; Liu, F.] Univ South China, Affiliated Hosp 1, Cardiac Intervent Imaging Ctr, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.;[Liu, F.] Chiang Mai Univ, Fac Nursing, PhD Degree Program, Chiang Mai 50000, Thailand.
通讯机构：
[Liu, F ] U;Univ South China, Sch Nursing, Hengyang 421001, Hunan, Peoples R China.;Univ South China, Affiliated Hosp 1, Cardiac Intervent Imaging Ctr, Hengyang Med Sch, Hengyang 421001, Hunan, Peoples R China.;Chiang Mai Univ, Fac Nursing, PhD Degree Program, Chiang Mai 50000, Thailand.
摘要：
objective: To assess the variations in radiation dose at different areas in the cardiac catheterization room during cardiac catheterization interventions. methods:To simulate the conventional operation in cardiac catheterization interventions, perform angiography on standard manikins ,the radiation dose was collected from 22 areas in the cardiac catheterization room under 8 projection angles, and each area was repeated 5 times, and the collected data was analyzed using one-way ANOVA and independent sample t-test. results:Analysis of the radiation dose in 22 areas under 8 projection angles revealed that the lowest radiation dose was found in the area at the end of the operating table in the cardiac catheterization room (p < 0.05), and the highest radiation dose was found in the area on the left and right sides of the X-ray tube (p < 0.05); the radiation dose in the area on the right side of the X-ray tube of the DSA machine was greater than that in the conventional standing area of the first operator (p < 0.05)，and the radiation dose in the conventional standing area of the second operator was greater than that in the conventional standing area of the first operator (p < 0.05); the radiation dose in the standing area of the first operator was highest in the cephalic position (CRA 30°) (p < 0.05), and the radiation dose in the standing area of the second operator was highest in the left anterior oblique position (LAO 45°) (p < 0.05); in the angle of RAO projection, the radiation dose in the right area of the X-ray tube was greater than that in the left area of the X-ray tube (p < 0.05). Under the RAO projection angle, the radiation dose from the right side of the X-ray tube of the DSA machine was greater than that from the left side (p<0.05), and the result was reversed at the projection angle of the LAO. conclusion:The radiation dose during cardiac catheterization interventions is lowest in the area at the end of the operating table, which can be used as a standing area for nurses and as an area for the placement of surgical equipment and supplies. At the same time, it is necessary to pay attention to the radiation dose to the second operator and to further improve the radiation protection measures for the second operator, and additional measures are needed to minimize the radiation dose to the operators in the cephalic position (CRA 30°) and in the left anterior oblique position (LAO 45°).
摘要：
BACKGROUND: Cardiac rehabilitation has showed the potential to improve health outcomes of patients with coronary heart disease. However, the adherence of patients participating in cardiac rehabilitation is unsatisfactory due to some barriers. The quantitative instrument for measuring cardiac rehabilitation adherence is scarce. Hence, the purpose of this study was to develop a scientific tool and assess its psychometric properties in patients with coronary heart disease. MATERIAL AND METHODS: The psychometric properties of the revised scale were tested with 509 patients. Item analysis was conducted to evaluate the discrimination and homogeneity of the scale. Content validity was evaluated by content validity index and Exploratory factor analyses and confirmatory factor analyses were used to examine the factor structure of the scale. Reliability was evaluated by Cronbach's coefficients and split-half reliability coefficients. RESULTS: A scale covering five dimensions and thirty-three items was developed for evaluating cardiac rehabilitation adherence. The content validity index of the scale was 0.96. In exploratory factor analysis, a five-factor structure model was confirmed, explaining 71.255% of the total variation. In confirmatory factor analysis, the five- factor structure was supported by appropriate fitting indexes. In terms of reliability, the Cronbach's α coefficient of the scale was 0.909 and the spilt-half reliability coefficient of the scale was 0.765. CONCLUSION: The newly developed self-completion scale is reliable and valid. It appears to be a sound instrument for nurses and a broader range of healthcare professionals to effectively evaluate the cardiac rehabilitation adherence.
期刊：
Journal of Orthopaedic Surgery and Research,2025年20(1):1-8 ISSN：1749-799X
通讯作者：
Zhou, YH;Huang, HY
作者机构：
[He, Yulian; Liu, Bo; Tang, Wen; Yuan, Runzhi] Univ South China, Affiliated Hosp 1, Dept Orthoped Ctr, Hengyang Med Sch, Hengyang City 421001, Hunan Prov, Peoples R China.;[Wang, Yiqi] Univ South China, Sch Nursing, Hengyang City 421001, Hunan Prov, Peoples R China.;[Zhou, Yanhui] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Nursing Dept, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.;[Huang, Huayong; Huang, HY] Univ South China, Affiliated Hosp 1, Dept Emergency Med Ctr, Hengyang Med Sch, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.
通讯机构：
[Huang, HY ; Zhou, YH ] U;Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Nursing Dept, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.;Univ South China, Affiliated Hosp 1, Dept Emergency Med Ctr, Hengyang Med Sch, 69 Chuanshan Rd, Hengyang City 421001, Hunan Prov, Peoples R China.
关键词：
Early rehabilitation;Hospital stay;Postoperative complications;Elderly patients;Hip fracture;A prospective cohort study
摘要：
Hip fractures in the elderly are a major global public health concern, with incidence projected to rise as populations age. Rehabilitation is critical to recovery after hip fracture surgery, but the ideal timing for initiation remains uncertain. While early rehabilitation, within 48 h post-surgery, is associated with better outcomes, its specific impact on hospital stay duration and postoperative complications is not yet conclusively established. This study aims to evaluate the effects of initiating rehabilitation within 48 h after hip fracture surgery on hospital length of stay and postoperative complications, compared to rehabilitation started one-week post-surgery in elderly patients. It is hypothesized that early rehabilitation will significantly reduce hospital stays and decrease the rate of postoperative complications. In this prospective cohort study, patients aged 65 and older are divided into early rehabilitation (within 48 h) and delayed rehabilitation (after one week) groups. Data will be collected using electronic medical records (EMR), standardized clinical tools (Barthel Index, Timed Up and Go), and patient-reported outcome measures (SF-36, EQ-5D). Statistical analyses will include t-tests and chi-square tests for outcome comparison, with multiple regression adjusting for potential confounders such as age, gender, and comorbidities. This study addresses a gap in current research by comparing early versus delayed rehabilitation for elderly hip fracture patients. The findings will contribute to the development of evidence-based rehabilitation protocols aimed at optimizing recovery, reducing complications, and improving the efficient use of medical resources.
期刊：
Asia-Pacific Journal of Oncology Nursing,2025年12:100702 ISSN：2347-5625
通讯作者：
Chen, YY
作者机构：
[Guo, Junchen; Xu, Xianghua; Chen, Yongyi; Hu, Yonghong] Hunan Canc Hosp, Dept Palliat Care, Changsha, Peoples R China.;[Guo, Junchen] Univ Wollongong, Sch Nursing, Wollongong, NSW, Australia.;[Zeng, Linghao] Univ South China, Sch Nursing, Hengyang, Peoples R China.;[Dai, Yunyun] Univ Wollongong, Hlth Serv Res Inst, Wollongong, NSW, Australia.
通讯机构：
[Chen, YY ] H;Hunan Canc Hosp, Dept Palliat Care, Changsha, Peoples R China.
关键词：
Palliative care;Shared-care management;Delphi technique;End of life care
摘要：
Objective Shared-care management (SCM) in palliative care is a collaborative model where shared care teams work in partnership with patients' original health care providers, employing multimodal strategies including consultations and coordinated referrals to enhance quality of care for patients. The evidence regarding its implementation remains fragmented and lacks detailed explanations, which impedes its application in clinical practice. This study aimed to develop a SCM standard of palliative care in adults in mainland regions of China.
Shared-care management (SCM) in palliative care is a collaborative model where shared care teams work in partnership with patients' original health care providers, employing multimodal strategies including consultations and coordinated referrals to enhance quality of care for patients. The evidence regarding its implementation remains fragmented and lacks detailed explanations, which impedes its application in clinical practice. This study aimed to develop a SCM standard of palliative care in adults in mainland regions of China.
Methods Initial standard framework identification was achieved via literature evidence summary. From April to August 2024, two rounds of Delphi method was conducted with the purposes of modifying the standard. To establish consensus, items with a mean importance score > 3.50 and the coefficient of variation of item scores < 0.25 were retained.
Initial standard framework identification was achieved via literature evidence summary. From April to August 2024, two rounds of Delphi method was conducted with the purposes of modifying the standard. To establish consensus, items with a mean importance score > 3.50 and the coefficient of variation of item scores < 0.25 were retained.
Results The first round involved 35 experts, with a follow-up participation of 33 in the second round. The Kendall concordance coefficients of the two rounds of experts consultation were 0.128 and 0.134, respectively (all P < 0.001), indicating consensus among the experts. At the end of the second round, the average importance score of each item was 4.73–5.00. A total of 8 modules including SCM team, applicable population, process of SCM, contents of SCM, start time, precautions, effectiveness evaluation and quality control, and the corresponding 22 items were finally identified in this standard.
The first round involved 35 experts, with a follow-up participation of 33 in the second round. The Kendall concordance coefficients of the two rounds of experts consultation were 0.128 and 0.134, respectively (all P < 0.001), indicating consensus among the experts. At the end of the second round, the average importance score of each item was 4.73–5.00. A total of 8 modules including SCM team, applicable population, process of SCM, contents of SCM, start time, precautions, effectiveness evaluation and quality control, and the corresponding 22 items were finally identified in this standard.
Conclusions The establishment of the standard in this study provides a critical framework that can be adopted by health care institutions to ensure that SCM services are delivered uniformly and effectively in mainland regions of China.
The establishment of the standard in this study provides a critical framework that can be adopted by health care institutions to ensure that SCM services are delivered uniformly and effectively in mainland regions of China.
摘要：
BACKGROUND: Good adherence to pre-exposure prophylaxis (PrEP) is critical for effective HIV prevention. Despite the growing awareness of PrEP, many individuals remain at a preliminary understanding stage and struggle to achieve sustained adherence. mHealth (mobile Health) technology is emerging as one of the promising tools in the HIV prevention cascade. While research on mHealth applications for HIV prevention is rapidly advancing, their effectiveness in promoting robust PrEP adherence and optimizing cascade outcomes remains inconclusive, with fragmented evidence limiting scalable implementation. OBJECTIVE: To evaluate the efficacy of mHealth tools in optimizing the HIV prevention cascade (from risk identification to PrEP adherence) among key populations (including men who have sex with men, bisexual individuals, sex workers, transgender populations and some other groups who at elevated risk of HIV acquisition). METHODS: We searched in PubMed, Cochrane Library, Web of Science, Embase, Ovid and CINAHL (EBSCO) from the inception to February 3, 2025. Our inclusion criteria focused on randomized controlled trials (RCTs). Literature screening and data extraction were performed independently by two authors. Methodological quality was assessed using Cochrane's Risk of Bias in Randomized Controlled Trials tool. The primary outcome was adherence to PrEP and secondary outcomes included PrEP use, HIV testing and number of condomless sex events. Analyses were performed using standardized mean difference (SMD) and 95% confidence interval (CI) for continuous variables and using odds ratios (OR) and 95% CI for categorical variables. Data analysis and forest plotting were carried out using R Statistical Software version 4.4.0. RESULTS: 16 RCT studies met the inclusion criteria. The results of the meta-analysis showed that mHealth interventions significantly promoted PrEP adherence (OR = 1.60, 95% CI [1.09, 2.35], ρ = 0.016) and HIV testing (OR = 1.63, 95% CI [1.39, 1.90], ρ < 0.01). It had also shown some effectiveness in promoting the use of PrEP. However, there were no significant effects on reducing the number of condomless sex events during the entire follow-up period. CONCLUSION: mHealth effectively enhances specific stages of the prevention cascade. However, further optimization of technology design and intervention is needed to address complex difficulties. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=533772, identifier PROSPERO CRD42024533772.
